In 2002, the ACR established the Pediatric Residents Program to provide a travel grant, complimentary registration, and a networking breakfast to 25 Pediatric Residents to the ACR Annual Scientific Meeting. Since its inception the program has funded 100 pediatric residents to ACR Annual Scientific Meeting of the participants 29% have entered a pediatric rheumatology fellowship program.
A major need is for all medical school curricula to include pediatric rheumatology, say Drs. Klein-Gitelman and White. The ACR has taken a keen interest in pushing for this commitment from all medical schools in the U.S., she says. “We need to teach everyone who will listen about the benefits of this field of medicine,” says Dr. White. “We have been successful in increasing the number of fellowships and raising funds to support our fellows,” she says.
Drs. White and Klein-Gitelman know what it is like to be the lone specialist in a practice and say that a new generation of mentors to guide future pediatric rheumatologists is also critical to meeting long-term goals.
Sharing the Load: A New Model
One unique mentoring effort is taking place in Arizona. “It had become the accepted norm that children are seen by adult rheumatologists,” says Paul Caldron, DO, head of Arizona Arthritis and Rheumatology Associates, Paradise Valley, AZ. Until recently, Arizona had no pediatric rheumatologists. “Most adult rheumatologists have some training in pediatrics, but it is fragmented,” he says. “New physicians are afraid to go solo because it is tough to make a living, they have no training in business, and above all there are no mentors to help in the practice with patient load and on-call schedules.”
His practice is the largest for rheumatology in Arizona and the surrounding states. In the past he has seen as many as four to five pediatric patients each day. “It was 25% of my practice,” he says. But that is now down to approximately 5%.
Dr. Caldron spearheaded an effort that resulted in a formal collaboration between his practice and the Children’s Hospital of Phoenix. The two developed a single contract that pays for the salary of a pediatric rheumatologist who splits his time three ways—two afternoons a week at the community clinic (office space and support staff provided), three afternoons at the hospital’s pediatric rheumatology clinic, and mornings on rounds seeing patients in the hospital.
“We split call coverage so that our new pediatric partner has on-call duty one night a week and one weekend a month,” says Dr. Caldron. “We seek his input. We have to be open to listen and understand the problems that our new colleague will have.”
